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Utilization Manager Jobs in Brandon, MS (NOW HIRING)

Humana

Compliance UM Nurse (Wed - Sun)

Jackson, MS · On-site

Become a part of our caring community The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent ...

FMOLHS

Experienced Case Manager - RN

Jackson, MS

The Case Manager directs the utilization review of patient charts, treatment plans, and discharge planning pertaining to the quality of care and treatment criteria for patients in a specific ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Brandon, MS

Utilization Manager information

See Brandon, MS salary details

$37.7K

$87.9K

$161.8K

How much do utilization manager jobs pay per year?

As of Aug 14, 2026, the average yearly pay for utilization manager in Brandon, MS is $87,890.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,500.00 and $105,700.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a utilization manager?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

More about Utilization Manager jobs

What job categories do people searching Utilization Manager jobs in Brandon, MS look for?

The top searched job categories for Utilization Manager jobs in Brandon, MS are:

What cities near Brandon, MS are hiring for Utilization Manager jobs?

Cities near Brandon, MS with the most Utilization Manager job openings:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Brandon, MS as of August 2026, with employment types broken down into 100% Full Time. Highlights an 75% In-person, and 25% Remote job distribution, with an average salary of $87,890 per year, or $42.3 per hour.

RN - Utilization Review - Utilization Review

University of Mississippi Medical Center

Jackson, MS • On-site

Other

This job post has expired 5 days ago. Applications are no longer accepted.

University Of Mississippi Medical Center rating

7.4

Company rating: 7.4 out of 10

Based on 47 frontline employees who took The Breakroom Quiz

348th of 1,059 rated hospitals

Job description

Hello,
Thank you for your interest in career opportunities with the University of Mississippi Medical Center. Please review the following instructions prior to submitting your job application:

  • Provide all of your employment history, education, and licenses/certifications/registrations. You will be unable to modify your application after you have submitted it.
  • You must meet all of the job requirements at the time of submitting the application.
  • You can only apply one time to a job requisition.
  • Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process.
  • Applications must be submitted prior to the close of the recruitment. Once recruitment has closed, applications will no longer be accepted.
After you apply, we will review your qualifications and contact you if your application is among the most highly qualified. Due to the large volume of applications, we are unable to individually respond to all applicants. You may check the status of your application via your Candidate Profile.
Thank you,
Human Resources
Important Applications Instructions:
Please complete this application in entirety by providing all of your work experience, education and certifications/
license. You will be unable to edit/add/change your application once it is submitted.
Job Requisition ID:
R00050784
Job Category:
Nursing
Organization:
Utilization Review
Location/s:
Main Campus Jackson
Job Title:
RN - Utilization Review - Utilization Review
Job Summary:
RN-Utilization Review is accountable to perform utilization management services for designated patient case load, including prospective, concurrent, retrospective, and denial management reviews by applying clinical protocols and review medical necessity criteria. Reports quality of care issues identified during the utilization management process to the appropriate manager.
Education & Experience
Education and Experience Required:
One (1) year of nursing experience in an inpatient setting.
Certifications, Licenses, or Registration required:
Valid RN license.
Knowledge, Skills & Abilities
Knowledge, Skills, and Abilities:
Knowledge of utilization review, discharge planning, case management, and managed care reimbursement. Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, CPT, and DSM-IV. Excellent interpersonal, verbal, written communication, and negotiation skills. Ability to gather data, prepare reports, and identify process improvements. Able to work independently, exercise sound judgment, and apply medical necessity guidelines with minimal supervision. Committed to quality patient care, customer service, safety, cost efficiency, and continuous quality improvement (CQI). Proficient in the use of computers and related software applications.
Responsibilities:
  • Performs prospective, concurrent, retrospective, and denials review for individual cases, including benefit coverage, medical necessity, appropriate level of care, and mandated services.
  • Assists in collecting and reporting financial and performance indicators, including case mix, length of stay, cost per case, resource utilization, readmission rates, denials, and appeals.
  • Uses data to drive decisions and implement performance improvement strategies related to case management, including fiscal, clinical, and patient satisfaction outcomes.
  • Collects and analyzes variances from the plan of care and collaborates with physicians and the healthcare team to address issues and improve outcomes.
  • Applies clinical appropriateness criteria to monitor admissions and continued stays, identifies at-risk populations, and refers cases to the care management physician advisor as needed.
  • Communicates with third-party payers to facilitate reimbursement certification, resolves payor issues, and completes utilization management and quality screening for assigned patients.
  • Works collaboratively with the interdisciplinary care team to ensure timely, appropriate patient management, remove barriers to care, and proactively address delays or discharge obstacles.
  • Ensures safe, high-quality care in compliance with policies, procedures, and standards, while managing time, supplies, productivity, and accuracy within budgetary guidelines.
  • The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time.

Physical and Environmental Demands:
Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, no handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, no lifting/carrying up to 50 pounds, no lifting/carrying up to 75 pounds, no lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, no driving, occasional kneeling, occasional pushing/pulling, occasional reaching, frequent sitting, occasional standing ,occasional twisting, and frequent walking. (Occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)
Time Type:
Full time
FLSA Designation/Job Exempt:
Yes
Pay Class:
Salary
FTE %:
100
Work Shift:
Day
Benefits Eligibility:
Grant Funded:
No
Job Posting Date:
07/7/2026
Job Closing Date (open until filled if no date specified):

What University Of Mississippi Medical Center employees say

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About University of Mississippi Medical Center

Sourced by ZipRecruiter

The University of Mississippi Medical Center (UMMC) is the state's sole academic medical center, focused on enhancing the lives of Mississippi residents through education, research, and healthcare. UMMC houses seven health science schools with over 3,000 enrolled students, and its researchers are renowned for their contributions to areas like heart disease, diabetes, hypertension, and cancer treatment. Their efforts not only improve health outcomes but also drive economic growth and job opportunities in the state.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Jackson, MS, US

Year founded

1955

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